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Delayed endodontic and prosthetic treatment of two traumatized incisors.

This case report describes the delayed endodontic and prosthetic treatment of two maxillary central incisors in a 16-year-old patient. Both teeth had been traumatized eight years previously. The examination revealed arrested root formation with wide open apices, periapical inflammation and inflammatory resorption. Endodontic treatment with calcium hydroxide led to formation of hard tissue barriers in both teeth so that definite obturation could be performed. One tooth was lost due to a deep crown-root-fracture and replaced by an intraosseous implant, whereas the other incisor was retained for nearly four years.

Adolescent↗

Implants in children: a case report.

A post-crowned, root-filled tooth in a 13-year-old child which is retraumatised resulting in palatal fracture of the root often necessitates removal of the root. The future treatment plan involves appropriate space management and restorative treatment. In this instance the root was retained in order to preserve alveolar bone until the patient was old enough for an implant.

Adolescent↗

Development of a stain shade guide to aid the measurement of extrinsic dental stain.

BACKGROUND: Accurate and reproducible assessment of extrinsic staining is pivotal to determining efficacy of some tooth whitening oral hygiene products. The aim of this study was: (1) to produce a stain shade guide to aid the in vitro and in vivo stain assessment (2) to assess intra- and inter-examiner reproducibility of stain assessment using the stain shade guide. METHOD: Using chlorhexidine and tea, perspex and acrylic teeth specimens were stained. The amount of staining on the perspex was measured with a spectrophotometer and the values obtained were assigned to the stained acrylic teeth, which were made into a stain guide. Using clinical photographs and a group of 10 volunteers, stain area and intensity were assessed using the stain guide and the recognized Lobene stain index by two examiners. The degree of intra- and inter-examiner reproducibility for these measurements were assessed using Cohen's kappa statistics. RESULTS: For both the clinical examination and use of photographs, intra-examiner reproducibility for stain intensity was improved when using the stain guide compared with the Lobene Index. Similarly, when assessing inter-examiner reproducibility, stain intensity kappa values were greater using the stain guide (kappa = 0.82) compared with the Lobene Index (kappa = 0.57). CONCLUSION: The findings of this study would suggest that the use of the stain guide could be of importance in the assessment of extrinsic dental stain.

Adolescent↗

The efficacy of a fluoride varnish in reducing enamel demineralization adjacent to orthodontic brackets: an in vitro study.

OBJECTIVES: To test the hypothesis that fluoride varnish is effective in reducing demineralization (white spot) lesions adjacent to bonded orthodontic brackets. DESIGN: Two similar samples of extracted bovine incisors, with bonded orthodontic brackets, were separated into an experimental group (fluoride varnish was applied) and control group (no fluoride varnish) to examine the preventive effects of fluoride varnish. SETTING AND SAMPLE POPULATION: The dental clinic of the State University of Maringá--UEM (Maringá, Paraná, Brazil). Thirty-eight extracted bovine incisors with bonded orthodontic brackets. EXPERIMENTAL VARIABLE: Fluoride varnish was applied topically to half of the sample of extracted bovine teeth. No varnish was applied to the other half. OUTCOME MEASURE: The depths of enamel demineralization (white spot) lesions were measured from polarized light microscopy images using image analysis software. RESULTS: The teeth in both the experimental and control groups had been exposed to a cariogenic environment twice a day for 35 days. Those teeth that had been treated with two applications of fluoride varnish (one at the outset and another 15 days later) demonstrated about 38% less mean lesion depth than teeth where no varnish had been applied. CONCLUSION: Orthodontists may wish to consider the application of fluoride varnish during fixed orthodontic therapy to help reduce the development of enamel white spot lesions.

Animals↗

Clinical experience of CNC-milled titanium frameworks supported by implants in the edentulous jaw: a 3-year interim report.

BACKGROUND: The use of computer numeric controlled (CNC)-milled titanium frameworks is a new technique for framework fabrication, and few clinical reports have been made on this treatment modality. PURPOSE: The goal of this study was to report the clinical performance of implant-supported prostheses with CNC-milled titanium frameworks in the edentulous jaw and to compare the results with prostheses provided with conventional cast frameworks during the first 3 years of function. MATERIALS AND METHODS: A consecutive group of 126 edentulous patients were provided by random distribution with 67 prostheses with CNC-milled titanium frameworks in 23 upper and 44 lower jaws and 62 conventional prostheses with gold-alloy castings in 31 upper and 31 lower jaws. Radiographic 1-year data and clinical 3-year data were collected for both the titanium and control group. RESULTS: One prosthesis was lost in each group owing to loss of implants, and the overall 3-year prosthesis cumulative survival rate was 98.2% for both groups. Patients with smoking habits experienced significantly more implant failures than nonsmokers (p =.006). Few problems were observed. No metal fractures were seen in the test group, whereas two frameworks and one abutment screw fractured in the control group. Resin veneer fractures were the most common complication, with a slightly higher incidence observed in the control group. CONCLUSIONS: Computer numeric controlled-milled titanium frameworks can be used as an alternative to conventional castings in the edentulous jaw, presenting clinical performance similar to that of conventional cast frameworks during the first 3 years of function. key words: computer numeric controlled, implant supported, prostheses, titanium

Computer-Aided Design↗

An all porcelain lingual bonded retainer: a case study.

In recent years, resin bonded metal retainers have been used to replace teeth in a conservative manner. In addition, porcelain laminates or veneers have been used in esthetic dentistry on single teeth in areas that previously dictated reductions of tooth structure. This paper describes a method of replacing a missing lower anterior tooth with an all porcelain bonded retainer.

Dental Bonding↗

Shade matching.

Explore the source record for details and available documents.

Color↗

"The view" and the canine connection: an atlas of mandibular anterior tooth esthetics.

Restoring splinted mandibular incisors and canines with full crown restorations has always presented a challenge in creating an esthetic illusion of reality of normal individual teeth. This treatise is designed to present the rules for mandibular anterior esthetics that have been distilled from almost 4 decades of clinical practice of restoring dentitions that have been severely compromised by the deformities of disease or accident. The resultant formula systematically creates the desired results with a high degree of predictability.

Crowns↗

Esthetic considerations in removable prosthodontics.

UNLABELLED: Patients requiring extensive replacement of teeth with removable prostheses are indeed esthetic orphans in many contemporary dental practices. Although the advent of successful osseointegration has dramatically reduced the need for removable prostheses, there are still many patients who for health, anatomic, psychological, or financial reasons are not candidates for implants. These patients deserve the same level of esthetic restorative dentistry as those who are restored with fixed prostheses. Clearly, the restorative dentist has the greatest flexibility from an esthetic standpoint with complete dentures. Soft and hard tissues can be replaced with contemporary characterized denture-base materials, and a truly infinite variety of tooth forms, shades, and arrangements can be used to meet the expectations of the most demanding patient. For partially edentulous patients, the major problem is designing a removable partial denture that avoids the unsightly display associated with conventional clasp assemblies. There are strategies available to accomplish this effectively while establishing an environment for optimal periodontal health, and to minimize destructive stresses on the abutment teeth. CLINICAL SIGNIFICANCE: This article discusses the procedures essential for providing an upscale, quality esthetic service with removable prostheses. Effective strategies to eliminate unsightly clasp assemblies with removable partial dentures are described.

Dental Abutments↗

Dynesthetic and dentogenic concept revisited.

UNLABELLED: The dynesthetic and dentogenic concept, when applied, provides a more natural, harmonious prosthesis, which not only is desired by patients, but also is a quality of care they deserve. Outstanding esthetics can be achieved by simple guidelines, using tooth molds specifically sculpted for males and females, arranging prosthetic teeth to correspond with personality and age and sculpting the matrix (visible denture base) with more natural contours. There is no reason for edentulous individuals to be provided with care of any less quality than that available with other procedures, such as crowns, bridges, veneers, or implant restorations. Providing this upscale product can be rewarding and satisfying to patient and operator alike. This concept produces superior results no matter what posterior occlusal scheme is employed but, in the opinion of the author, works best when used in conjunction with a noninterceptive linear occlusion approach (not to be confused with lingualized occlusion), which precludes anterior contact. CLINICAL SIGNIFICANCE: Dentogenics provides an approach to esthetics in prosthodontics that enables the dentist to create a restoration in harmony with the patient's objective personality. This concept considers gender, age, and personality to restore the patient's dignity and unique individuality that has been missing in far too many prostheses.

Age Factors↗

Use of a modified ovate pontic in areas of ridge defects: a report of two cases.

UNLABELLED: A modified design for ovate pontics is proposed to achieve the esthetic, functional, and hygienic requirements for fixed partial dentures. This design should aid the clinician in preparing the edentulous area, thus resulting in less discomfort for the patient because little to no ridge augmentation is required. The same emergence profile can be developed as with the classic ovate pontic design. CLINICAL SIGNIFICANCE: A modified ovate pontic has the following advantages: excellent esthetics because it produces a correct emergence profile; fulfilled functional requirements; greater ease of cleaning as compared with the ovate pontic; an effective air seal, which eliminates air or saliva leakage; the appearance of a free gingival margin and interdental papilla; elimination or minimization of the "black triangle" between the teeth; and little or no ridge augmentation required prior to the final restoration.

Adult↗

Bonding acrylic teeth to acrylic resin denture bases: a review.

Partial or complete dentures are more commonly constructed for the elderly group of the population. Teeth debonding from the dentures can be frustrating to the patients as well as the dentist. Research has been carried out and is continuing to study the issue of bonding acrylic teeth to the denture base resin. The present review takes into account the majority of research papers published in the last five decades for determining the bond strength. Selection of more compatible combinations of denture base resins and acrylic teeth may reduce the number of prosthesis fractures and the resultant repairs.

Acrylic Resins↗

The use of milk as a saliva substitute.

Xerostomia, a clinical manifestation of salivary gland dysfunction, affects many people. These individuals frequently sip liquids to alleviate the discomforts associated with hyposalivation. Milk appears to have many of the chemical and physical properties of a good saliva substitute. Besides the obvious benefit of providing moisture and lubrication for the dehydrated mucosa, milk buffers oral acids, reduces enamel solubility, and contributes to enamel remineralization. These anticariogenic factors are generally attributed to the high calcium and phosphate content along with the milk phosphoproteins that strongly adsorb to enamel. Patients with xerostomia frequently have difficulty in obtaining proper nutrition due to problems associated with lubricating, masticating, tasting, and swallowing food. Milk is a food with high nutritional quality that would certainly benefit most patients with xerostomia. Because of the nutritional, anticariogenic, and moisturizing properties of milk, patients with xerostomia may find milk of value as a saliva substitute to help reduce the oral health problems associated with hyposalivation.

Animals↗